Moon, Gerald Rodger
Moon, Gerald Rodger is an individual health care provider with primary practice located at 2809 W Willow Knolls Rd G Rodger Moon Dds, Peoria IL 61614. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Moon, Gerald Rodger can be contacted via phone (309) 682-2090.Contact Information
Primary practice address
2809 W Willow Knolls Rd G Rodger Moon Dds
Peoria IL 61614
Phone: (309) 682-2090
Fax: (309) 682-0903
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 19A13409 | Illinois |
Profile Details
| NPI number | 1669516688 |
|---|---|
| LBN Legal business name | Moon, Gerald Rodger |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2007 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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